Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

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College of Health Care Sciences - Physical Therapy Department

Publication Date / Copyright Date



Nova Southeastern University. College of Health Care Sciences.


Strengthening exercises for the lumbar extensor musculature represent the most common form of exercise therapy employed by physical therapists in clinical management of adults with chronic low back pain (CLBP). Despite the popularity of lumbar extensor strengthening exercises, the dose response relationship for lumbar extensor strengthening exercise in the clinical management of CLBP is not well established and specific guidelines to assist physical therapists in the prescription of lumbar extensor strengthening exercises for this population have not been fully developed. The primary aim of this investigation was to contribute to the understanding of the dose response relationship for lumbar extensor strengthening exercise in the clinical management of adults with CLBP. This objective was achieved by conducting a retrospective analysis of medical records from a cohort of adults with CLBP who completed a structured protocol of physical therapist supervised lumbar extensor strengthening exercises over a 5 year period at a hospital based outpatient rehabilitation center. After controlling for heterogeneity in baseline demographic and clinical characteristics, the results of the statistical analysis procedures suggested that performance of the exercise protocol once weekly for 12 weeks was associated with clinically meaningful improvements in pain intensity, perceived disability, and lumbar extensor function. There was insufficient evidence to conclude that higher training frequencies were necessarily associated with better clinical outcomes. The adults with CLBP most likely to benefit from the structured protocol of lumbar extensor strengthening exercises were those individuals who demonstrated the greatest deficits in lumbar extensor function during their baseline performance testing procedures.


Physical Therapy

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